Provider Demographics
NPI:1902327919
Name:WARREN, LINDSAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PONTIAC BUSINESS CENTER DR STE C
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9171
Mailing Address - Country:US
Mailing Address - Phone:803-865-7871
Mailing Address - Fax:877-482-0775
Practice Address - Street 1:100 PONTIAC BUSINESS CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-9171
Practice Address - Country:US
Practice Address - Phone:803-865-7871
Practice Address - Fax:877-482-0775
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice